What is Complex PTSD [Complex Post Traumatic Stress]

Complex Post Traumatic Stress or  C-PTSD is something we see and hear a lot about in our lives. C-PTSD refers to someone who has experienced long term trauma that has resulted in a variety of symptoms and impacts on the individual and their system. 

What Is it?

Although overlapping with general PTSD diagnosis, C-PTSD is something that is chronic, long term trauma. PTSD is often related to one event or experience that results in someone experiencing various trauma symptoms. When multiple events occur or the experience lasts for a long time, people are at higher risk for developing C-PTSD.

C-PTSD can be created due to various factors from living within an abusive household, being in a toxic relationship, living somewhere where there is a lot of violence around, being a first responder, being oppressed or discriminated against, or being at war. 

One of the hardest things for people to understand in trauma is that trauma is about the individuals experience. So while something may be traumatic for one person, it may not be traumatic for another. Often, people are dismissive of people’s traumas because they do not understand which results in a lack of empathy and compassion for the person who is struggling with it. 

This dynamic and invalidation often creates an exacerbation of symptoms for the individual. Feelings of hopelessness, shame, and powerlessness are common with CPTSD.  When people do not believe or dismiss people’s experiences it certainly increases the impact of the C-PTSD for that individual. 

C-PTSD Symptoms

Symptoms can look like: 

• Difficulty regulating emotions, (e.g. extreme anger, depression, suicidal thoughts, and quick swings from one to another)
• Avoidance about what reminds the individual about the trauma(s)
• Intrusive memories or thoughts (not being able to change or control their thoughts)
• Losing memories of the trauma  
• Reliving memories from the trauma through flashbacks or feeling like it is happening again
• Dissociating, or feeling detached from oneself (almost like they are floating or in a movie)
• Changes in self-perception, including feeling totally different from other people and feeling ashamed or guilty
• Significant difficulties in relationships, including difficulty trusting others, or even seeking an abuser, codependency, difficulty trusting themselves
• Distorted perceptions of reality or the people part of this traumatic event. (e.g. placing all the power to this person, becoming obsessed with him or her, or becoming preoccupied with revenge)
• Difficulty sleeping or having nightmares about the event(s)
• Loss of a system of meanings, such as losing one’s core beliefs, values, religious faith, etc.
• Shift in presentation or the way they seem to people around them
• High risk behaviors
• Difficulty taking criticism or feedback from others. Experience things as personal attacks. 

Although this list includes many of the symptoms, it is challenging to name them all. Often times after reflecting on these skills it is hard to differentiate between this experience and some personality disorders.

Personality disorders (PD) are a way of taking in a variety of factors to determine when C-PTSD is accompanied or surpassed into a PD.  Often with PD’s we look towards factors such as genetic, responsiveness to treatments, length of episode, and intensity and duration of symptoms. Various PD’s have other symptoms that accompany many listed above. 

If you demonstrate the symptoms listed above or any of the aforementioned information feels true for you, it is almost always helpful to connect to a mental health provider who engages in trauma work to help you manage and address your needs. 

IAM

Throughout the pandemic the Inner Aspects Method (IAM) has been my go to trauma modality as it only requires the client and a quiet space. IAM is a method of therapy that is similar to Interal Family Systems (IFS). It focuses on the various parts of ourselves that make up who we are. Just like we have multiple parts of our body, IAM identifies their various aspects of ourselves as people. 

The benefits of using this particular modal is that it allows clients to identify their younger selves and work through the trauma(s) that have happened to them throughout their lives, which as you can imagine is very helpful with those healing from C-PTSD. The idea is figuring out the ways inner aspects have been harmed and impacted by the trauma, finding the strategies that are utilized. Recognizing and holding compassion for those strategies as survival techniques. And being open to finding new strategies that are more healthy and adaptive. 

Additionally, the IAM focuses on building compassion for ourselves and our various inner aspects. This includes being able to provide and meet the needs of our own inner aspects rather than relying on external forces to solely regulate. The idea is to co-regulate within yourself and meet the needs of yourself and bring consciousness to the decisions one is making surrounding their emotional responses. This consciousness reduces reactivity, brings intention and compassion to those applying the techniques. 

For those with C-PTSD, this can help de-personalize the trauma, address feelings of shame or powerlessness, build compassion for themselves, and identify ways to regulate and respond more consciously in their emotional experiences. The concepts of providing and building self compassion, internal  validation, empowerment, and self love allow for healing to take place. 

I have also found that applying the IAM method with Compassionate Communication (Non-violent communication). Eye Movement Desensitization Reprocessing Therapy (EMDR) have also been useful supporting modalities to help others healing from C-PTSD. IAM and EMDR together have allowed for the ability to fully engage in the inner aspects and reprocess trauma. 

C-PTSD is SUCH a difficult thing to go through. It is so important for people with it to have the supports and resources needed to help address these struggles to heal. And learn how to find strategies to support your health and wellness.

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